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Countries Eye WHO Exit Despite Legal Uncertainty

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Several world leaders, including Argentina’s President Javier Milei and Hungary’s Viktor Orbán, have expressed their intentions to withdraw from the World Health Organization (WHO), following the United States’ decision to leave the global health body last month. However, the legal complexities of such a move present an unclear path forward.

No Clear Exit Mechanism in WHO Constitution

Unlike other international organizations, the WHO’s constitution—an international treaty signed by nearly every country—does not include a formal withdrawal clause. The organization was founded in 1946 with the intention of fostering universal cooperation in global health, making the idea of member states leaving a legal gray area.

“The idea in the field of public health was for the WHO to be as universal as possible,” said Stéphanie Dagron, an international law professor at the University of Geneva.

While the U.S. reserved the right to exit when it joined in 1948, no such provision exists for other nations. This means countries like Argentina and Hungary face legal uncertainty in their attempts to leave.

How Countries Could Withdraw

Despite the lack of a formal exit clause, international law provides some guidance. The 1969 Vienna Convention states that if a treaty does not specify withdrawal terms, member states must provide one year’s notice before leaving.

This suggests that Argentina and other nations would have to navigate a year-long process before officially cutting ties with the WHO, potentially slowing down their exit plans.

Pedro Villarreal, a researcher in global health law at the German Institute for International and Security Affairs, noted that while no clear precedent exists, withdrawal is still legally possible. “The fact that an international treaty does not envisage withdrawal does not mean that countries cannot withdraw,” he explained.

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Inactive Status: A Middle Ground?

While an outright departure remains uncertain, historical precedent suggests that nations could instead take on an “inactive” status. When the Soviet Union stopped participating in the WHO in 1949, it was not seen as a formal withdrawal but rather as a period of inactivity. The USSR later rejoined in 1956 without needing to ratify the constitution again.

Whether countries like Argentina or Hungary could follow a similar path remains an open question. Steven Solomon, the WHO’s principal legal officer, acknowledged the ambiguity, saying, “The question of whether withdrawal is possible, and if so, how it would be given effect, and under what conditions, is a matter of interpretation.”

Potential Consequences of Withdrawal

If countries were to go inactive or withdraw, they would face significant consequences. Member states are required to pay annual fees, and those that stop contributing could lose their voting rights at the World Health Assembly. More importantly, they may also forfeit access to WHO-backed health programs and initiatives.

For nations with struggling healthcare systems, this could mean reduced support in areas such as disease prevention, vaccine distribution, and emergency health response.

What Happens Next?

For now, no formal withdrawal requests have been submitted, and the topic is not currently on the agenda for the WHO’s next World Health Assembly in May.

“At the moment, it’s a political announcement,” Dagron said, emphasizing that any final decisions on withdrawal will likely involve further legal and diplomatic negotiations.

As more countries weigh their options, the global health community is left watching to see how this unprecedented situation unfolds.

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Health

Study Finds Men Far More Likely Than Women to ‘Hit the Wall’ in Marathons

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Men are significantly more likely than women to experience the dreaded marathon phenomenon known as “hitting the wall,” according to a large international study that analysed the performances of more than 870,000 runners over a 26-year period.

The research, published in the journal Scientific Reports, examined the results of 873,334 finishers in the Berlin Marathon between 1999 and 2025. Researchers found that although men generally complete marathons faster than women, they are much more likely to suffer a dramatic slowdown during the later stages of the race because of less consistent pacing.

According to the study, men are almost twice as likely overall to experience a sudden decline in speed during a marathon. In some performance categories, they were found to be up to six times more likely than women to “hit the wall,” a term commonly used to describe severe physical exhaustion caused by depleted energy stores.

Researchers said the findings point to differences in race strategy rather than physical ability alone. Men were more likely to begin races at an aggressive pace, increasing the risk of fatigue before reaching the finish line.

The study concluded that “men, regardless of performance level, are more prone to aggressive pacing and catastrophic deceleration.” The authors suggested that greater willingness to take risks and higher levels of confidence may encourage many male runners to start faster than they can realistically sustain over the full 42.195-kilometre distance.

Women, on the other hand, displayed more controlled pacing throughout the race. Researchers found they were better at regulating their effort from start to finish, reducing the likelihood of a significant loss of speed during the closing kilometres.

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The report described women as showing “superior self-pacing abilities and greater resistance to decision-making fatigue,” characteristics that can be particularly valuable during endurance events.

Maintaining a steady pace is widely regarded as one of the most important factors in marathon performance. Running too quickly during the opening stages can rapidly consume the body’s glycogen reserves, leaving athletes without enough energy to sustain their speed in the final part of the race.

The researchers noted that pacing is “the most critical tactical determinant of performance” in marathon running, making strategic decision-making just as important as physical fitness.

The findings could influence how coaches and runners prepare for long-distance races. Rather than focusing solely on speed, the study suggests that adopting a realistic race plan and maintaining a consistent pace throughout the event may improve overall performance and reduce the chances of a late-race collapse.

With marathon participation continuing to grow worldwide, the researchers believe a better understanding of pacing strategies could help runners of all abilities achieve stronger and more consistent results.

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Study Links Higher Coffee Consumption to Lower Risk of Liver Disease

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Regular coffee consumption may help reduce the risk of serious liver diseases, including cirrhosis, liver cancer and liver-related deaths, according to a new study published in the journal Clinical Gastroenterology and Hepatology.

The research found that people who consumed higher amounts of coffee, including decaffeinated varieties, were less likely to develop chronic liver conditions than those who drank little or no coffee. The findings add to growing evidence that coffee may play a role in supporting long-term liver health, although researchers stressed that the results do not prove a direct cause-and-effect relationship.

The study examined data from more than 350,000 participants enrolled in the UK Biobank, one of the world’s largest long-term health research projects. None of the participants had cirrhosis or liver cancer at the beginning of the study. Researchers monitored their health over a period of 13 years to assess how coffee consumption affected liver-related outcomes.

According to the findings, participants who drank five or more cups of coffee each day had a 32 percent lower risk of developing cirrhosis than those who consumed little or no coffee. They also recorded a 47 percent lower risk of liver cancer and a 42 percent reduction in deaths linked to liver disease.

Researchers found additional indicators of improved liver health among regular coffee drinkers. Participants with higher coffee intake showed lower levels of liver fat, liver iron, fibrosis and inflammation. Blood tests also revealed increased levels of proteins associated with healthy liver function, while markers linked to liver scarring and inflammation were generally lower.

The findings come as liver disease continues to pose a major global health challenge. A separate study published in 2023 estimated that liver disease causes around two million deaths each year, accounting for about four percent of all deaths worldwide. Men account for nearly two-thirds of those fatalities.

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Despite the encouraging results, the researchers urged caution in interpreting the findings. Senior study author Ju Dong Yang said moderate coffee consumption appears to be beneficial for people who already enjoy drinking coffee and tolerate it well.

“Our findings support moderate coffee consumption for people who already enjoy and tolerate it well,” Yang said.

He added that the study does not provide sufficient evidence to recommend that people who do not currently drink coffee should begin doing so solely to reduce their risk of liver disease.

Health experts continue to advise that maintaining a healthy weight, limiting alcohol consumption, eating a balanced diet and managing conditions such as obesity and diabetes remain the most effective ways to reduce the risk of chronic liver disease. Researchers said additional studies are needed to better understand which compounds in coffee may contribute to its potential protective effects.

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Lancet Review Finds mRNA Vaccines Safe and Highly Effective, Calls for Wider Global Access

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A comprehensive review of data covering billions of administered doses of mRNA vaccines has concluded that the technology remains both safe and highly effective in preventing infectious diseases, with researchers urging governments and health organisations to focus on expanding global access.

The review, published in The Lancet, examined evidence gathered since mRNA vaccines were first deployed on a large scale during the COVID-19 pandemic. Researchers found that the vaccines continue to provide strong protection against severe illness while serious side effects remain uncommon.

Unlike conventional vaccines, mRNA vaccines work by delivering genetic instructions that enable the body’s cells to produce a harmless viral protein. This process trains the immune system to recognise and respond to future infections without altering a person’s DNA.

According to the review, mRNA vaccines were 87% effective in preventing confirmed SARS-CoV-2 infections within 14 to 42 days after vaccination. The vaccines also demonstrated 93% effectiveness in preventing hospital admissions and 94% effectiveness in preventing deaths related to COVID-19 during the same period.

Researchers noted that immunity declines over time, but booster doses restore a significant portion of the lost protection.

The review also assessed vaccine safety across billions of administered doses. It found that serious adverse events, including myocarditis, pericarditis and anaphylaxis, occurred very rarely. Most reported reactions, such as pain at the injection site, fatigue and fever, were mild to moderate and typically resolved within a few days.

“Across billions of administered doses, serious adverse events have been rare, well characterised, and consistently outweighed by the substantial protection conferred against severe disease, hospitalisation, and death,” the researchers wrote.

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The review concluded that the vaccines have proven effective across a broad range of populations, including children, older adults, pregnant women and people with weakened immune systems.

Researchers also highlighted the growing potential of mRNA technology beyond infectious diseases. They said ongoing research could lead to personalised cancer vaccines designed to match an individual patient’s tumour characteristics, opening new possibilities for targeted treatment.

Co-author Manish Sadarangani of the University of British Columbia and BC Children’s Hospital Research Institute said mRNA vaccines have already changed how the world responds to emerging infectious diseases and could continue to play an important role in preventive medicine and cancer care.

The review also noted that improvements in vaccine storage, including higher-temperature storage methods and freeze-drying technologies, could simplify transportation, reduce waste and improve access in remote regions.

Despite these advances, the researchers stressed that manufacturing capacity and equitable distribution remain major challenges. They called for greater investment in local production, technology transfer and stronger regulatory systems, particularly in low- and middle-income countries.

Co-author Robin Shattock of Imperial College London said expanding manufacturing networks and strengthening regional production capabilities would shorten supply chains, lower costs and help ensure countries have faster access to vaccines during future global health emergencies.

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